Evaluation of the CHNRI Process for Setting Health Research Priorities

Background: The Child Health Nutrition Research Initiative (CHNRI) method is a tool used in health research prioritisation (RP). Though the method is widely used, inherent challenges remain: the method may be affected by on-going research where self-selected participants have personal interests; no evidence-based guidelines exist on the sample size of the expert group; and little evaluation has been conducted on the quality and impact of the method. This PhD presents an example of the application of the method, studies these inherent challenges, and assesses the quality and impact of previously conducted CHNRI exercises. Methods: The methods include a comprehensive review of RP approaches published between 2000 and 2014; coordination of two global RP exercises; statistical analyses of previously conducted CHNRI exercises; and assessment of the quality of method’s application using an evaluation framework and a survey. Results: Approximately one in four RP exercises used the CHNRI method between 2000 and 2014. In the previously conducted CHRNI exercises, substantial potential for self-selection bias was noted. Statistical analyses identifying a minimum sample size of experts yielded varied results across different CHNRI exercises. The evaluation of the quality of the process identified that the CHNRI exercises met most of the requirements to be qualified as good practice. Conclusion: To my knowledge, this is a first attempt to evaluate some key components of the CHNRI method. The varied results in the sample size analyses prevented any recommendation being made at this point. Many RP exercises end once the priorities are identified, without assessing whether the RP exercise is effective in mobilizing funds for identified priorities. Future RP exercises should add a follow up at a later time point to assess whether funding has been allocated and if so, how much funding has been allocated to priority areas.